Magnesium plays crucial roles in the nervous system and is important for proper muscle and nerve function along with energy production. Poor absorption of magnesium through the gut from various inflammatory conditions and poor diet are some causes of magnesium deficiency. In addition, even a small about of alcohol can quickly lead to depletion of magnesium storage. There has been much interest in the past few years of using magnesium supplementation and its therapeutic potential. We will review some mechanisms of supplementing magnesium for therapy and if there is a potential benefit to include magnesium in IV ketamine infusions for individuals with treatment-resistant disorders.
Magnesium plays crucial roles in the nervous system and is important for proper muscle and nerve function along with energy production. Poor absorption of magnesium through the gut from various inflammatory conditions and poor diet are some causes of magnesium deficiency. In addition, even a small about of alcohol can quickly lead to depletion of magnesium storage. There has been much interest in the past few years of using magnesium supplementation and its therapeutic potential. We will review some mechanisms of supplementing magnesium for therapy and if there is a potential benefit to include magnesium in IV ketamine infusions for individuals with treatment-resistant disorders.
What is magnesium and how does it work?
Magnesium is an important mineral that when depleted can cause havoc on the nervous system and body. Magnesium plays a role in hundreds of biological processes, and low levels are linked to inflammation, insulin resistance, and risk of various diseases and cancers. Specifically, magnesium regulates calcium absorption, with calcium also being involved in a host of essential processes such as bone formation, blood clotting, muscle contractions, and regulating nerve and heart rhythm functions. Having a proper ratio of magnesium and calcium rather than supplementing with calcium alone appears to be necessary for optimal function. Low levels of magnesium are also associated with decrease synthesis of vitamin D, which again is vital for health and mental wellbeing.
Magnesium deficiency associated with depression and anxiety
Decrease levels of magnesium may hinder proper function of nerve cells resulting in depression and anxiety. Supplementation with magnesium has been linked to decrease levels of depressive symptoms. According to one randomized-controlled trial, supplementation of magnesium for six weeks improved both depression and anxiety scores. Another study noted similar findings and diminishing anti-depressants effects within two weeks of stopping magnesium, indicating that depletion of magnesium may happen quickly without proper diet or supplementation.
Other positive effects with magnesium supplementation may include less muscle cramps and headaches. Interestingly, patients who are on antidepressants such as SSRIs may find that the addition of magnesium may increase the efficacy of antidepressants or allow for usage of lower dosages of these medications. Antidepressants such as Selective serotonin reuptake inhibitors (SSRIs) may be associated with undesirable side effects that include decreased libido, weight gain, and disturbances with mood and sleep. Thus, the ability to lower or taper off an antidepressant may be appealing to those suffering from these issues.
Ketamine infusions with the addition of magnesium
Ketamine has been shown to have robust anti-depressant effects which are rapid and safe. This is quite appealing given that other options of therapy including antidepressants such as SSRIs may have a less than optimal rates of success, a delayed response, and sides effects. The question remains about patients who are treatment-resistant and are having minimal anti-depressant effects from IV ketamine alone.
Treatment-resistant individuals may benefit from the addition of magnesium in their IV Ketamine infusions. Some studies suggest that magnesium and ketamine act synergistically and may be an option for the treatment of mood disorders. Individuals with low levels of magnesium may benefit from a combination of ketamine and magnesium. Additionally, studies suggest that the addition of magnesium with ketamine can be beneficial for patients suffering from depression and have a super-additive effect. Another study showed that the addition of magnesium with ketamine infusions improves pain control and has opioid-sparing effects.
The IKT approach to magnesium supplementation
When we evaluate individuals as potential candidates for ketamine infusions, we pay special attention to other important aspects in life such as proper sleep, nutrition, exercise, and stress reducing practices such as meditation. In our minds, there is no doubt that being deficient in various vitamins and minerals will be detrimental to health and specifically mental wellbeing.
It makes sense that eating a healthy diet that supplies key nutritional elements is a superior means to optimize your health. However, with a vast majority of people being deficient in vitamins and minerals such as vitamin D and magnesium, we offer the addition of magnesium sulfate to IV ketamine infusions for individuals who lack sufficient positive effects from ketamine alone. We recognize that more studies and strong evidence are needed to support these practices, although supplementation of magnesium certainly appears safe with minimal downside or risk.
About the Author
Dr. Ray Rivas, a former general and trauma surgeon with over a decade of experience utilizing ketamine, became a ketamine therapy specialist to treat mental health and pain after witnessing its profound impact on his hospital trauma patients and his own mental health. As the founder and medical director of Innerbloom Ketamine Therapy in San Luis Obispo, California, Dr. Rivas applies his extensive medical expertise to provide safe, evidence-based ketamine treatments for mood disorders, including depression, anxiety, PTSD, and chronic pain. His passion lies in helping patients find relief and rediscover hope through personalized, compassionate care.